Clearly, children are subject to the same range of health problems as are their accompanying adults. They often adapt well, but have their own specific needs, which may require some preparation.
IN GENERAL:
1. Never leave children alone.
2. Carry food and drinks, especially for babies and the very young, which may not be available at your destination.
3. Take clothing appropriate for the climate and season.
4. Check that all medications and mosquito protection are suitable for children.
5. Ensure that all routine vaccinations are up to date and others recommended for your destination have been given.
Air Travel
In general terms, travel by air does not constitute an increased risk for babies or children. There are certain exceptions:
1. Premature infants, or those with heart or lung problems, may have problems compensating for the reduced oxygen levels at cruising altitudes. Where travel by air is necessary, provisions may have to be made with the airline.
2. Over-feeding during ascent or descent may cause abdominal bloating and discomfort. Equalisation of ear pressure is best achieved by swallowing and sucking techniques, rather than by providing extra food and drink. Babies with ear drainage tubes in place should have no trouble with ear pressures.
Airport security (Australia)
Where you are travelling with a baby, baby products in reasonable amounts required for the flight are exempt from liquids, aerosols and gels (LAG) restrictions. Where the volume of baby products is deemed excessive by security screening staff, it will not be allowed through the screening point.
If you are carrying any baby products have them ready for inspection. It is also reasonable for security screening staff to expect that you will be carrying a baby with you. So if you are travelling in a large group or as a family, ensure that you and your baby go through the security screening point together.
Baby products may include:
baby milk;
sterilised water;
baby juice;
baby food in liquid, gel or paste form; and
wet wipes.
Security screening staff have the final say regarding what items are allowed through the screening point. If the security screening officer decides that you are attempting to take unreasonable amounts of non-prescription medication or baby products through the screening point, you may be asked to surrender some or all of these products. If you fail to do so you will not be allowed to proceed through the screening point.
The Australian Government controls the export of medicines subsidised through the Pharmaceutical Benefits Scheme (PBS) and travellers are urged to check the Medicare web site before carrying medications overseas.
The protection of children
1. In Australia, each child must have his or her own passport and cannot be included on the passport of a parent.
2. It is a criminal offence to have sex with a child under the age of 16 and parents seeking childcare facilities should research the standards applying in their country of destination. Children under six must be accompanied by an adult on international flights. Do not allow nametags to be visible to strangers.
3. Children under the age of 18 may require special documentation in some countries. Travellers are advised to check the entry requirements of their intended destination before travelling.
4. Airlines have different regulations for the safety of children. The regulations set down by QANTAS may be found at their web site.
5. Accidents and injuries account for more deaths than do infectious diseases. Parental monitoring is essential as drowning is a common occurrence.
6. Adolescents in particular should be cautioned about engaging in body piercing, tattooing, and casual sexual activity in foreign countries due to the risk of blood-borne and body fluid-transmitted infections. Also, they should be discouraged from unaccompanied activities in urban areas, especially at night.
Food and drinks for children
1. Parents of children with food allergies should discuss their requirements with the airline at the time of booking
2. Commonly acquired gastrointestinal infections may be rapidly life threatening to children and should be avoided at all costs. Parents, especially when travelling in third world countries, should be familiar with food and water precautions, the management of diarrhoea and the frequent cleaning of toys and pacifiers.
3. Oral rehydration solutions are often available in developing countries, but parents are advised to carry their own.
4. Antibiotics, such as azithromycin (10 mg/kg/day orally for 3 days) are of secondary importance, but shown to be effective.
5. Anti-protozoal therapy will be prescribed in certain areas.
6. Anti-diarrhoeals such as loperamide and bismuth subsalicylate are not advised for children less than 3 years of age.
7. Vaccines: Dukarol is available to children over the age of two and protects against bacterial diarrhoea. Discuss with your TCA doctor.
More information is available in the “Traveller’s Pocket Medical Guide and International Certificate of Vaccination” available from Travel Clinics Australia, throughout Australia.
Appropriate clothing, footwear and protection.
1. Avoid over exposure to the sun with sun protection. If sun block is used with insect repellent, it should be applied first.
2. Clothing and netting, which protect against mosquitoes and other insects should be utilised in appropriate destinations. DEET to a concentration of less than 30% should be considered. Permethrin impregnated external clothing and nets have an excellent safety profile.
3. Children should avoid walking barefoot in rural areas of the tropics and in many developing countries.
4. Children are susceptible to altitude sickness (acute mountain sickness (AMS)) and may require Diamox (acetazolamide).
Medications for children
1. Children recovering from otitis media will need particular care while in the air. Earache may be reduced by chewing or swallowing. Pseudoephedrine is ineffective and should be avoided. Sedatives should be avoided.
2. A medical kit for children might include rehydration powder, an antihistamine, paracetamol, sun protection and anti-malarial medication.
Vaccinations
1. Ensure all routine vaccinations are up to date. Sometimes these will need to be started earlier than usual.
2. Special vaccinations, such as those for yellow fever, must be discussed with your Travel Clinic doctor.
3. Some vaccinations, such as the quadrivalent meningococcal vaccines are not recommended for children under two years.
4. In older children and adolescents, hepatitis B and meningococcal vaccination is necessary, especially if sexual activity or tattooing is a possibility.
Malarial protection
1. All children travelling to malaria risk areas, including young or breastfed infants, should use personal protection methods to avoid mosquito bites.
2. Preventive drugs (eg chloroquine, proguanil, Malarone Junior) are used in the same way as for adults, but care with dosing and the avoidance of toxicity is essential. Drugs will be recommended according to the sensitivity of the malaria parasite in the destination country and your travel health doctor will discuss these. Antimalarial medications should be stored in childproof containers, out of reach of children, to avoid accidental overdose.
3. Some drugs are unsuitable for children and the medications prescribed will take into account the destination and its associated risks.
4. As for adults, prophylaxis should begin before entering the malarial area; continue for the duration and for some time after leaving the malarial area.
1. Never leave children alone.